Provider Demographics
NPI:1841253549
Name:OSTLER, DAVID RICK (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RICK
Last Name:OSTLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8944 W QUAIL AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-2429
Mailing Address - Country:US
Mailing Address - Phone:623-594-1941
Mailing Address - Fax:
Practice Address - Street 1:20542 N LAKE PLEASANT RD
Practice Address - Street 2:SUITE #109
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-9749
Practice Address - Country:US
Practice Address - Phone:623-566-1310
Practice Address - Fax:623-566-1331
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD56191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ926727OtherAHCCCS